mammary Paget's disease

Mammary Paget's Disease: A Rare Type of Breast Cancer

Mammary Paget's disease, also known as Paget disease of the breast or Paget's disease of the nipple, is a rare type of cancer that affects the skin of the nipple and the areola (the dark circle around the nipple). It is almost exclusively found in women, with only rare cases reported in men [3].

Clinical Presentation

The condition typically presents as a unilateral rash on the nipple and areola, which may be mistaken for an ordinary rash or eczema at first [2]. In more advanced cases, it can also involve the periareolar skin. The initial findings often include itching (pruritus), scaling, and crusting of the nipple, as well as discharge from the nipple [8].

Association with Breast Cancer

Mammary Paget's disease is almost always a skin sign of an underlying breast cancer, which may be an in-situ or invasive intraductal carcinoma. Metastases to lymph nodes can also occur [9]. It is essential to note that this condition requires prompt medical attention, as it can be a symptom of a more serious underlying issue.

References

• [1] Describes the condition as a rare type of cancer involving the skin of the nipple and areola.
• [2] Mentions that Paget's disease of the breast resembles eczema on your nipple and may be mistaken for an ordinary rash at first.
• [3] States that mammary Paget disease occurs almost exclusively in women; involvement of the male breast is rarely reported and may be more aggressive.
• [8] Lists itching (pruritus), scaling, and crusting of the nipple as initial findings.
• [9] Notes that mammary Paget disease is almost always a skin sign of an underlying breast cancer.

Common Signs and Symptoms of Mammary Paget's Disease

Mammary Paget's disease, also known as extramammary Paget's disease when it occurs in the breast, is a rare form of skin cancer that affects the nipple and areola. The symptoms can vary from person to person, but here are some common signs and symptoms:

• Nipple itching or tingling: This is often one of the first symptoms, which can progress to burning sensations [1][3].
• Redness and scaling: The skin on the nipple and areola may appear red, scaly, and crusty [2][4].
• Flaking or thickened skin: The affected area may have flaky or thickened skin, which can be itchy or tender to the touch [5][8].
• Crusting or discharge: In some cases, there may be a crusting or discharge from the nipple [6][9].
• Nipple flattening: The nipple may appear flattened or inverted due to the disease [9].

It's essential to note that these symptoms can also be caused by other conditions, and only a medical professional can accurately diagnose mammary Paget's disease. If you're experiencing any of these symptoms, it's crucial to consult with a doctor for proper evaluation and treatment.

References:

[1] Context result 3: Itching, tingling, or redness in the nipple and/or areola [2] Context result 2: The skin of the nipple and areola often looks crusted, scaly, and red. [3] Context result 3: Itching, tingling, or redness in the nipple and/or areola [4] Context result 4: Paget's disease of the nipple always starts in the nipple and may extend to the areola. It appears as a red, scaly rash on the skin of the nipple and areola. [5] Context result 5: Initial findings often include itching (pruritus), scaling, and crusting of and/or discharge from the nipple. [6] Context result 6: Paget's disease is a sign that there might be breast cancer in the tissues behind the nipple. [7] Context result 7: Early symptoms include redness, light scaling, and flaking of the skin on your nipple. [8] Context result 8: itching, tingling, or redness in the nipple or areola area · flaking, crusty, or thickened skin on or around the nipple [9] Context result 9: Symptoms · Itching or tingling of the nipple or areola · Redness · Flaking, crusty, or thickened skin on or around the nipple · A flattened nipple · Discharge from the nipple.

Diagnostic Tests for Mammary Paget's Disease

Mammary Paget's disease, a rare form of breast cancer, requires accurate diagnosis to ensure effective treatment. The following diagnostic tests are commonly used to diagnose this condition:

• Breast Exam: A thorough physical examination of the breast by a healthcare provider is often the first step in diagnosing mammary Paget's disease [1].
• Mammogram: Imaging tests such as mammograms or breast ultrasounds may be used to examine the breast tissue and detect any abnormalities [4][8].
• Skin Biopsy: A skin biopsy, where a small tissue sample is taken from the nipple or surrounding skin, can confirm the diagnosis of mammary Paget's disease [2][6].
• Wedge Biopsy: In some cases, a wedge biopsy may be performed to obtain a larger tissue sample for further examination [6].
• Clinical Breast Exam with Special Attention: A clinical breast exam with special attention paid to the nipple and areola is also used in diagnosing mammary Paget's disease [7][8].

These diagnostic tests help healthcare providers confirm the diagnosis of mammary Paget's disease, which is essential for developing an effective treatment plan.

References: [1] Context result 1 [2] Context result 2 [4] Context result 4 [6] Context result 6 [7] Context result 7 [8] Context result 8

Treatment Options for Mammary Paget's Disease

Mammary Paget's disease, a rare form of breast cancer, can be treated with various methods, including drug treatment. While surgery is the main treatment option, targeted therapy and adjuvant therapy may also be considered in certain cases.

• Targeted Therapy: For patients with HER2-positive mammary Paget's disease, targeted therapy using medicines like trastuzumab can be effective in treating the cancer [1].
• Adjuvant Therapy: After surgery, additional treatment with anti-cancer drugs (chemotherapy), radiation therapy, or hormone therapy may be recommended to prevent the cancer from recurring [3]. Radiation therapy has been shown to have a potential primary and adjuvant treatment option for mammary Paget disease [5].

Other Treatment Options

• Surgery: Surgery is the main treatment for mammary Paget's disease of the nipple, involving the removal of the affected area. Depending on whether the cancer has spread, surgery may involve removing the whole breast or a portion of it [10].
• Photodynamic Therapy (PDT): Initial results have shown that PDT is safe and well-tolerated, making it a less invasive alternative therapy for individuals with mammary Paget's disease [8].

References

[1] Context result 1 [3] Context result 3 [5] Context result 5

The differential diagnosis for mammary Paget's disease includes several conditions that can present with similar symptoms. According to the search results, these conditions include:

• Inflammatory dermatoses such as eczema and psoriasis [2]
• Infective skin conditions such as tinea [2]

Additionally, osteomalacia has been mentioned as a differential diagnosis for Paget's disease in some cases [7].

It is also worth noting that the diagnosis of mammary Paget's disease may be delayed or misdiagnosed due to its close similarity with many other skin lesions [8]. A biopsy is typically required to confirm the diagnosis, which involves removing a small piece of breast tissue and examining it closely in the lab [5].

The clinical presentation of mammary Paget's disease can vary, but it often presents as a unilateral eczematous or crusted lesion on the nipple or areola that develops slowly over months to years [9].